Kaiser to raise senior health plan premiums on 3 isles

The state's largest health maintenance organization, with about 249,000 members, is replacing several existing Medicare plans with higher-cost policies.

Kaiser's Senior Advantage "Basic" and "Enhanced" plans will be discontinued on Maui for roughly 3,700 individuals on Dec. 31. They will be replaced on Jan. 1 by a "competitively priced" Senior Advantage Maui plan with a premium of $194, up from $38 for the "Basic" policy and $180 for the "Enhanced."

The "Essential" and "Essential Plus" plans will be eliminated on the Big Island at year's end for about 3,900 individual members. The insurer will offer the Senior Advantage Hawaii Island plan for $194, up from this year's premiums of $63 and $202.

Affected members were notified about the plan changes this week and must re-enroll in the new Medicare policies to continue coverage with Kaiser.

Meanwhile, rates are rising for some individual Senior Advantage members on Oahu, who will be automatically enrolled in 2017. On Jan. 1, Oahu seniors will pay $59 for the "Basic" plan, up from $38 this year. Those in the "Enhanced" plan will see a $1 decline to $179 compared with $180 currently. Kaiser has 8,600 individual Senior Advantage members on Oahu.

Kaiser does not offer Medicare plans on Kauai.

"We know that these changes may be difficult for some seniors, so there are financial assistance programs available. Given the rising cost of medical care and drugs and Medicare reimbursement rates, these changes are necessary," Kaiser spokeswoman Laura Lott said in an email. "Closing the Maui and Big Island plans was a difficult decision, and we did this only after reviewing all the options available to us at this time. We want to be here to care for all our members for many years to come. To do that, we have to be financially stable."

Kaiser -- both a medical provider and health insurer -- said the current combination of premiums, co-pays and Medicare reimbursements don't adequately cover the costs of medical care, prescription drugs and other services.

"Medicare reimburses health plans at a different rate, depending on where you live," Lott said. "Hawaii Island and Maui have significantly lower reimbursement rates than anywhere else in the country, making it challenging to cover the rising cost of medical care and prescription drugs."

Maui resident Bill Entrekin, a 72-year-old veteran, was notified Saturday that his Senior Advantage plan, which cost him about $150, would be canceled at the end of the year. He is worried that he won't be able to afford a more expensive policy.

"I'm surprised and I'm upset. I'm retired. I'm not working. (Any increase) is real big," he said. "There's been no increase in Social Security payments for several years now. Now the cost of everything is taking off. These kinds of things, they're small for most people, but they're catastrophic for people like me. They're pushing all the old people over the edge of the cliff."

Members should receive information about the new plans in the mail by the end of the week, Kaiser said.